“How do non- English speaking Europeans negotiate their healthcare in the UK?”

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Abstract

Background: A problem that often occurs in the interaction between healthcare professionals and non-English speaking Europeans are language barriers. Language barriers and unfamiliarity with the UK’s healthcare system may prevent non-English speaking Europeans to interact with the healthcare services the same way that native- born people do. Many Europeans speak English as a second or third language, which is a considerable barrier to the navigation and negotiation of an already unfamiliar NHS system. As the European migration population in Britain continues to grow (ONS, 2016), a greater number of non-English speaking patients can be expected to increase. There is a shortage of studies based on Europeans health in the UK whose ability to speak English was limited or non- existent. Previous research concerning access to healthcare services for those with no functional English mainly focused on the experiences of other ethnic minorities. But, perceptions of health and illness as well as ways to negotiate healthcare vary from culture to culture and are not necessarily representative for Europeans. Thus, the experience and strategies that non- English speaking Europeans develop to access healthcare services might be different than other ethnic minorities’.
Objective: Previous research found that ethnic minorities still have less access to healthcare and are less satisfied with the treatment they receive (Hanssens et al 2016, Gerrish 2001, Rhodes et al 2003, Jacobs et al 2004, Shi et al 2009, Kaur et al 2014). Therefore, this study aims to explore and critically evaluate how non- English speaking Europeans negotiate their healthcare in the UK and what strategies they use to access services.
Method: Qualitative method was used and data was obtained through semi- structured interviews with eight non- English speaking Europeans permanently living in the UK (Table 1). This method allowed to explore European immigrants’ experience and challenges in accessing healthcare services, and to gain data in their own words and elaborate on areas that had greater importance to them. A combination of convenience and purposive sampling was used to approach participants. Most of the interviews were conducted with assistance of formal interpreters. The present researcher was mindful of ethical considerations regarding data collection and its use (Appendix 1). The conversations from the interviews were then transcribed and analysed identifying the main themes.
Results: There were numerous challenges revealed during the interviews that prevented participants from seeking and receiving healthcare services in the UK. Participants in the study were found not taking full advantage of the primary and preventative healthcare services because of the language barrier and different health perception. Non- English speaking Europeans tend not to access primary healthcare services unless they have had a serious health problem. Instead, they were found self-medicating, thereby potentially putting themselves at risk. European immigrants appeared to have a little expectation and low sense of entitlement of using some of the UK’s healthcare services due to limited English proficiency. Furthermore, participants in the present study were found heavily relying on interpreters to negotiate their healthcare in the UK. Majority of them reported using family or friend interpreter because professional interpreters were not easily available. Also, non-English speaking Europeans revealed that due to unsatisfactory healthcare quality and perceived lengthy waiting times, they often travel abroad to get some treatments quicker and to avoid ineffective communication with healthcare providers. Therefore, although non- English speaking Europeans permanently live in the UK, they obtain some of their health needs in other European countries.
Conclusion: The findings of this study indicated that language barriers in access to healthcare services in the UK do exist. Language barriers were in many ways problematic when accessing healthcare services and can influence the patient’s decision to use the service. There were many disadvantages of being unable to communicate fluently in English when accessing healthcare in the UK. The lack of effective communication affects the quality of care for non-English speaking European patients. For many non-native speakers’ language is more than just a tool of communication, and many prefer using their native language particularly in vulnerable and high involvement services like health care. This study identified that there is a great need for further research.

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